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Adults born preterm at-risk of early chronic diseases

New review helps fill gap for doctors to treat patients

MONTRÉAL, December 7, 2015 – Premature birth is linked to an increased risk of heart disease, high blood pressure, pregnancy complications and other chronic diseases in adulthood. A new review in CMAJ (Canadian Medical Association Journal) aims to help physicians identify and treat adults who were born premature to prevent and manage health conditions.

In Canada, 8% of babies are born premature (before 37 weeks’ gestation) and more than 90% survive, due to advances in health care. Young adults born preterm have a 40% increased risk of premature death compared with people born at term. However, there are currently no guidelines for long-term management of people born prematurely, who are at higher risk of certain chronic diseases.

“By identifying patients who were born prematurely, we can take steps to prevent and manage chronic diseases for which they may be at risk to help prevent early death and allow a patient to live a longer, healthier life,” states Dr. Thuy Mai Luu, staff pediatrician, Division of General Pediatrics, CHU Sainte-Justine Research Center, and associate professor, Faculty of Medicine, University of Montreal.

Adverse health conditions associated with preterm birth may include a higher risk of hypertension and heart anomalies associated with heart failure, increased risk of diabetes, including gestational diabetes in pregnant women, impaired respiratory function and suboptimal bone mass that can lead to osteoporosis and fractures.

Recommendations

Regular measurement of blood pressure to help manage risk of early heart disease, including monitoring of pregnant women who were born preterm

Pulmonary function testing for adults born preterm who have long-term respiratory issues

To prevent osteoporosis and risk of fractures, adults who were born preterm should eat a calcium-rich diet and participate in weight-bearing exercise

Physicians should consider preterm birth as a possible risk for metabolic syndrome.

“It is our role as clinicians to identify patients at-risk by enquiring about perinatal history to the same extent that we ask about smoking or family history of early cardiovascular death,” concludes coauthor Dr. Anne Monique Nuyt, neonatal specialist and researcher at CHU Sainte-Justine and Full Professor at University of Montreal.

Authors are now trying to better understand how prematurity influences the development of chronic diseases such as diabetes, hypertension and osteoporosis by conducting the Health of Adult born Preterm Investigation (HAPI) clinical study, which follows-up a cohort of about four hundred young adults, half of which are born preterm and the other half born term as the control group.

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About the CHU Sainte-Justine Research Center

CHU Sainte-Justine Research Center is a leading mother-child research institution affiliated with Université de Montréal. It brings together more than 200 research investigators, including over 90 clinician-scientists, as well as 360 graduate and postgraduate students focused on finding innovative prevention means, faster and less invasive treatments, as well as personalized approaches to medicine. The Center is part of CHU Sainte-Justine, which is the largest mother-child center in Canada and second most important pediatric center in North America. More on research.chusj.org

Thuy Mai Luu is a pediatrician, epidemiologist and researcher at CHU Sainte-Justine, and assistant clinical professor in the Department of pediatrics, Faculty of Medicine, at Université de Montréal. She co-heads the website “The Best in Daily Life” designed to provide families with children aged 0-2 years that are born preterm information and practical advice regarding the baby’s development and behaviours, from the time of birth to life back home. She coordinates the HAPI study together with Dr. Anne Monique Nuyt, who is a neonatal specialist and researcher at CHU Sainte-Justine Research Center, where she heads the Foetomaternal and Neonatal Pathologies Research Axis. Dr. Nuyt is Full Professor at the Department of Pediatrics, Faculty of Medicine, University of Montreal. Both are supported by grants of the Fonds de recherché du Québec – Santé.

About the HAPI (Health of Adult born Preterm Investigation) study

The Health of Adult born Preterm Investigation (HAPI) aims at better understanding how prematurity influences the development of chronic diseases such as diabetes, hypertension and osteoporosis, by measuring the global health of young adults who were born preterm between 1987 and 1994, in terms of heart, lung, metabolism, kidney, eyes, and bone health. For more information about HAPI or to enter the cohort, please visit the HAPI website.